February 22, 2021 Dear Child Care Provider, The Department of Social Services, Division of Child Care Services (CCS) is pleased to announce a new grant opportunity focused on enhancing infant and toddler care environments. Funding is intended to help with the purchase of high-quality items in supporting the development of infants and toddlers in your licensed child care program. This includes indoor and outdoor equipment or manipulatives such as child-size tables and chairs, safe places to crawl and climb; etc. Grant awards are contingent upon available funding and whether the request meets the grant criteria, see attached suggestions. We encourage you to reach out to your regional Early Childhood Enrichment (ECE) office to assist with selection of items that optimize infant and toddler development within your program. Maximum grant award for a child care center is $2,000, and there is no match for this grant opportunity. This grant does follow the health and safety grants for all other criteria including reimbursement and requiring all purchases must be made within the provider’s individual contract period. The application and more information related to the terms of this grant opportunity can be found on the CCS website at: https://dss.sd.gov/childcare/. Review and approval of applications will be on a first come, first served basis, based on the date the complete application is received. A complete application consists of: a signed application, at least one bid/verification of cost for each requested item, complete risk assessment questionnaire, complete FFATA form, verification of liability insurance, business is registered with SD Secretary of State, and a completed W-9 form. Mail all documents to:

Child Care Services 3900 W Technology Circle, Ste. 1 Sioux Falls, SD 57106

If you have any questions about the application process, contact Abby Roderick at 605-367-5444 ext. 1000439 Sincerely, Carrie Johnson Division Director

DEPARTMENT OF SOCIAL SERVICES DIVISION OF ECONOMIC ASSISTANCE 3900 W TECHNOLOGY CIRCLE, STE. 1

SIOUX FALLS, SD 57106 PHONE: 605-367-5444

WEB: dss.sd.gov

Quality Infant and Toddler Environments:

Children under 3 learn through continuously exploring and interacting with their

environment, which includes the emotional climate of a child care setting as well

as the physical space.

Babies and toddlers need safe spaces for quiet and active play (both inside and

outdoors), safe spaces for sleeping, and spaces to interact one-on one with

individual caregivers.

Within the environment they need toys and activities selected primarily for

individual interests and abilities.

The regional Early Childhood Enrichment programs can provide assistance in

choosing items that would best enhance your program for the infants and toddlers

in your care. Their contact information can be found at:

https://dss.sd.gov/childcare/educationalopportunities/sites.aspx

Considerations when purchasing items for Infant and Toddler spaces:

1. Safety:

• Age & developmentally appropriate equipment made of non-toxic material

• non-slip floors

• stable shelves, objects, and fixtures with rounded corners

2. Health:

• surfaces are easy to clean

• item fits the space it will be used in

3. Comfort:

• tiles and rugs

4. Convenience:

• storage units

5. Child Size Space:

• child size furniture

• low to the ground climbing, exploring

6. Flexibility:

• tables, storage units that can used for multiple purposes

7. Movement:

• multi-level equipment: slopes, play pits, moveable platforms

8. Choice:

• variety of textures, activities, equipment

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Licensed Day Care Center Infant & Toddler Grant Application

Submit before August 1, 2021

Information/Instructions

Quality based Infant & Toddler Grant The Division of Child Care Services is offering funding specific to improving the care of infants and toddlers in child care programs. This grant opportunity is focused on supporting quality indoor and/or outdoor environments for infants and toddlers. The grant funding is available to help state licensed programs purchase items such as child-size tables and chairs, climbers, blocks, counting and sorting toys, etc. Consumable items do not qualify. Items purchased prior to the approved grant application are not eligible for grant funding. Minimum/Maximum Grant Allowed Minimum grant award is $150. Maximum grant award: $2,000. Submission of Application The completed and signed application and all required attachments should be mailed to the Division of Child Care Services, 910 E. Sioux Avenue, Pierre, SD 57501. Providers may not apply more than once per calendar year. Required attachments:

• At least one bid/verification of each items cost, including tax and shipping;

• ‘Before’ pictures are required to help justify the need, when applicable;

• Verification of liability insurance; and

• Verification of vehicle insurance if you provide transportation; • W-9 form, FFATA form, and Risk Assessment Questionnaire

No Guarantee of Award Awards are contingent on available funds and whether or not the request meets grant criteria. It is possible that only a portion of your grant request will be approved. If this occurs, the Award Letter you receive will specify which portions of the grant request have been funded. If grant application is approved:

• You will receive an Award Letter, a Contract, and a Final Grant Report & Reimbursement Form.

• Purchases must be made within the start and end dates of the contract you receive. Any purchases made outside those dates will not be reimbursed.

• If funded, you will be required to pay for the costs of the approved project up front and CCS will reimburse the cost after the reimbursement form and receipts are received.

• The final reimbursement will be based the actual receipts submitted or the grant award provided by the State, whichever is less. The submitted receipts or invoices must be dated and indicate each specific item purchased.

Grant Repayment Repayment of the grant will be required if you do not continue to provide regulated child care for one year from the award date. Repayment will be pro-rated based on registration end date and date of the grant award.

Keep this page for your records

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Licensed Day Care Center Infant & Toddler Grant Application

Program Information

Name of Child Care Program

Provider License Number

Facility Address

City/Zip Code

County

Mailing Address (if different)

City/Zip Code

Contact Person for Grant

Title

Owner Name, if different

Contact Email Address

Contact Phone Number

Total Grant Request $

• Length of time as a licensed child care provider ___________________________________

• Total number of children enrolled in your care: ___________________________________

• Total number of infants (birth up to age 1) in your care: ______________________________

• Total number of toddlers (1yr up to age 3) in your care: ______________________________

• Are you currently serving children on Child Care Assistance? Yes □ No □

• If so, how many are currently in your care? _________________________________________

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Licensed Day Care Center Infant & Toddler Grant Application

Project Description The Division of Child Care Services encourages applicants to contact the regional Early Childhood Enrichment Program if they need help completing this section of the application. Please describe the project or items you are requesting funds for in as much detail as possible and provide insight as to how this grant funding will help you improve the care of infants and toddlers in your program. Project Description:

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

Understanding children’s development and learning at different ages is a crucial starting point in creating environments that support the development of children in care.

• The newest category of orientation training is child development including all domains. Explain how your choices for this grant purchase relate to the child development domains. ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ _________________________________________________________________________________

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• The SD Early Learning Guidelines were developed for early childhood professionals who nurture and support the development of young children. Explain how choices for this grant purchase relate to the SD Early Learning Guidelines.

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

• Provide a summary of how each of the purchases you have requested will help enhance the care you are able to provide to infants and toddlers in your program. ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

________________________________________________________________________________

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Licensed Day Care Center Infant & Toddler Grant Application

Budget Worksheet If funded, you will be required to pay for the costs of the approved project up front. The final reimbursement will be based the actual receipts submitted or the grant award provided by the State, whichever is less. Maximum Award: $2,000 Day Care Center Step 1: Enter the projects/items requested to help improve the quality of care for infant and toddlers in your care

Quality-Related Expenses

Enter description of project/item

Quantity Cost per item

Shipping & tax cost

Total Cost

$

$

$

$

$

$

$

$

$

$

$

$

$

TOTAL COST: $

TOTAL GRANT REQUEST: Enter Total Cost -OR- $2,000 maximum award, whichever is less.

$

Step 2: Attach at least one bid for any contracted labor or item(s) to be purchased. Please check that the item(s) and/or bid(s) amounts match the worksheet above.

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Licensed Day Care Center Infant & Toddler Grant Application

Terms of Agreement

I hereby apply for an Infant & Toddler Grant from the Office of Child Care Services to assist financially in improving the quality of the infant and toddler care in my child care program. If awarded funding, I understand and agree to the following terms and provisions:

• Grant funds must be spent for only the approved items in the amount specified, as defined on my Award Letter.

• If my program needs have changed, I will contact Child Care Services; I understand that I will not be reimbursed if I make substitutions without prior approval.

• I understand that I will not be reimbursed if I purchase an item outside of the Grant Award begin or end date, as defined on my Award Letter.

• I will only purchase my approved items and complete and send in the Final Grant Report & Reimbursement Form, by the Grant Award end date.

• I understand that I will be paid on a reimbursement basis, after I provide verification of project completion and documentation of expenditures with the Final Grant Report & Reimbursement Form.

• I understand that I will be obligated to repay all or a portion of the compliance grant I receive if I do not continue to provide registered or licensed child care for one year from the award date. Repayment of the grant will be required within the following increments if I terminate my registered or licensed child care program (based on termination date from the date of the grant award):

o If grantee provides child care for less than 6 months 100% of the Grant Award o If grantee provides child care for 6 – 12 months 50% of the Grant Award

Signature:

I certify that the information I have provided in this application is true and correct, to the best of my knowledge.

Authorized Signature (owner of facility) Date

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Grant Application Checklist

Provider License Number is listed on Application Form, page 1 Signed application, page 5 Bids are attached Pictures are attached, if applicable Other documentation verifying need is attached, if applicable Completed W-9 is attached Completed Risk Assessment Questionnaire is attached Business is registered with the South Dakota Secretary of State Completed FFATA form is attached A copy of liability insurance is attached A copy of vehicle insurance, if providing transportation, is attached Grant application has been reviewed and is complete

State of South Dakota BFM-0001 (V03/201907)

Substitute W-9

SEND TO THE STATE AGENCY YOU SEND INVOICES

DO NOT send to IRS

Taxpayer Identification Number (TIN) Verification Print or Type Please see attachment or reverse for complete instructions. This form can be made available in alternative formats to qualified individuals upon request. Legal Name (as entered with IRS) If Sole Proprietorship enter your Last, First MI

Entity Designation (check only one) Required

Individual / Sole Proprietor Partnership C Corporation S Corporation Limited Liability Company - Individual Limited Liability Company - Partnership Limited Liability Company - Corporation Governmental Entity Hospital Exempt from Tax or Government Owned

Long Term Care Facility Exempt from Tax or Government Owned

Trust/Estate All Other Entities (specify e.g. 501(c)(3), etc.)

Taxpayer Identification Number (TIN)

Business Name If doing business as (DBA) or enter business name of Sole Proprietorship

Order Address (where order should be mailed) PO Box or Number and Street, City, State, ZIP + 4

Remit Address (where check should be mailed) PO Box or number and street, City, State, ZIP + 4

___ ___ ___ ___ ___ ___ ___ ___ ___

Exemptions Check Only One Required

Social Security Number (SSN) Employer Identification Number (EIN) Individual Taxpayer Identification Number for U.S. Resident Aliens (ITIN)

Exempt payee code (if any):

Exemption from FATCA reporting code (if any):

Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number, AND 2. I am not subject to back up withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by

the Internal Revenue Service (IRS) that I am subject to back up withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding.

3. I am a U.S. person (including a US resident alien). Printed Name

Printed Title

Telephone Number ( )

Signature Date (mm/dd/yy)

Optional Direct Deposit Information Your Bank Account Number Checking Savings

Bank Routing Number (9-digit ABA #)

Name on Bank Account

THIS IS A:

new direct deposit change of existing (providing old banking information required to change existing) Old Bank Account Number

Old Routing Number (9-digit ABA #)

You must provide the previous banking information to make a change.

Required e-mail address (Please make this LEGIBLE) If you provide an email address you will be sent electronic notification when a payment is issued. You will also receive a PIN for use when

logging into the SD Vendor Self Service website at http://bfm.sd.gov/vendor. We will NOT share your email address with anyone or use it

for any purpose other than communicating remittance information.

Information below to be completed by the State Agency. Vendor Number required for any new vendors added to SDAS. State Agency: Agency Contact: Date: Vendor Number assigned by SDAS:

Subrecipient Name:

Program Name(s):

Grant Period(s):

Yes/No

2.    Amount

**Amounts less than $100,000 only complete sections 1. through 6.I.

3.    Funding of Entity

Automated Manual Combo

5.    Program Complexity

Check all that apply

Numerous programmatic requirements and/or must strictly adhere to

regulations

Matching funds or Maintenance of Effort are required

Yes/No

f. Has your entity been in business for less than 3 years?

Risk Assessment Questionnaire - DSS Subrecipients

Various types of program reports are required

1. Eligible to Conduct Business with the State (answering yes to any of these questions results in ineligibility to receive

funds)

Is your entity on the federal debarrment list (www.sam.gov)?

Is your entity on the Bureau of Administration's debarrment list (boa.sd.gov)?

Is your entity not in good standing with the SD Secretary of State (sos.sd.gov)?

Amount of your award ( If award amount is unknown, an estimated award amount should be

used. )

What percentage of funding would this grant be for the entity in comparison to the entity's

total funding?

4.    Accounting System

Type of accounting system used by the entity

$0.00

0%

  The entity further subcontracts out the program

6.I. Entity Risk (Questions Must Be Answered for All Grants)

a. Is your entity receiving an award for the first time from the State?

b. Will your entity be receiving funds prior to expenses being claimed?

c. Does a conflict of interest exist between the applicant and Department issuing the grant?

d. Does the program leader have more than 3 years of experience in managing the scope of services required under this

program?

e. Does your entity's financial and programmatic staff who will oversee this grant have more than one year prior federal

grant award experience?

g. Does your entity anticipate subcontracting or subgranting the grant onto other entities?

h. If applicable, is there any indication that your entity may have difficulty meeting the required match?

04/17 1 Risk Assessment Questionnaire.xlsx

Yes/No

k. Are there currently any unresolved audit issues?

If yes,please explain:

a. Does your entity have prior experience with similar programs?

6.II. Entity Risk (Questions Must Be Answered for 100,000 or Larger Grants)

Examples of other items: (1) having new or substantially changed systems or software packages, i.e. accounting, payroll, reporting, technology, administration; (2)

turnover in personnel, i.e. business, award management, program; (3) external risks including: economic conditions, political conditions, regulatory changes &

unreliable information; (4) loss of license or accreditation to operate program; (5) new activities, products, or services; (6) organizational restructuring; (7) where

indirect costs are included, does the organization have adequate systems to segregate indirect from direct costs.

b. Does your entity maintain policies which include procedures for assuring compliance with the terms of the award?

c. Does your entity have an accounting system that will allow you to completely and accurately track the receipt and

disbursements of funds related to the award?

d. If applicable, does your entity have a system in place which can track employee time spent on multiple programs?

e. If applicable, does your entity have a procurement system or procedures in place that meet the minimum federal

requirements for procurement?

f. If applicable, does your entity have a property management system that meets the minimum federal requirements for

equipment management?

g. If applicable, does your entity have an adequate system or procedures in place for tracking and evaluation of in-kind

match?

h. Has your entity been audited in the past 3 years? (select N/A if has been in business for less than this amount of time)(Per 2 CFR

200.501, this is required for all entities who receive over $750,000 in federal funds annually.)

i. If your entity received over $750,000 in federal funds from all sources total last year, was a single audit conducted on the

entity per 2 CFR 200.501.

j. Did your entity have one or more audit findings in their last single audit regarding program non-compliance and/or

significant internal control deficiency?

l. Does your entity intend to claim use of personal property as an expense?

m. Did your entity have any of the below items within the past year?

I declare and affirm that all the information listed above is to the best of my knowledge and belief and is in all things true and

accurate.

Name: ________________________________________________________ Date:____________________________________________

04/17 2 Risk Assessment Questionnaire.xlsx

South Dakota Department of Social Services

V 04-19 FFATA

1

DSS Agreement # 20-08___-______

SUB-RECIPIENT INFORMATION FFATA REQUEST FORM

Federal Funding Accountability and Transparency Act (FFATA) (To Be Completed By Sub-recipient)

Business Name: _____________________________________________________________________

Dun & Bradstreet 9-digit Number: _________________Parent Entity DUNS Number: ______________

Tax ID Number: _____________________Parent Entity Tax ID Number:________________________

Physical Street address: (Not PO Box)_____________________________________________________

City: ______________________________State:____________________Zip+4: __________________

Entity Email Address: _________________________________________________________________

Contact Person:_____________________________________Title______________________________

Phone Number:__________________________Email Address: _______________________________

Is the sub-recipient a: Non-profit entity Foreign entity For-profit entity

Do you have a Federally-negotiated indirect cost rate? Yes No Rate:_______________

Did your entity receive over $750,000 in federal funds from DSS and other sources combined in the last

year? Yes No

Did your entity have an audit finding in the last single audit regarding program non-compliance and/or

significant internal control deficiencies? Yes No

Please answer the following sections as required:

Part A: Transparency Act

I. In the preceding fiscal year did you receive 80% or more of

annual gross revenues in federal awards? Yes No

(if Yes, see question II.; if No, skip to Part C)

II. Did you receive $25,000,000 or more in

annual gross revenues in federal awards? Yes No

(if Yes, see question III.; if No, skip to Part C)

III. Does the public have access to information about the compensation of

senior executives of your entity through periodical reporting to the SEC? Yes No

(if Yes, skip to Part C; if No, and questions I. and II. were answered Yes, then you are required by the

Transparency Act to provide the information required in Part B*)

Part B: (If Applicable*)

If qualifications were met in part A, the Transparency Act requires us to provide the names and total compensation** of the

five most highly compensated officers. Please attach a list of this information to this form or complete the information below.

1. ___________________________________________ $ ____________________________________

2. ____________________________________________$ ____________________________________

3. ____________________________________________$ ____________________________________

4. ____________________________________________$ ____________________________________ **Total compensation is defined as cash and noncash value earned by the executive during the past fiscal year including the following: salary & bonus,

award of stock. stock options, and stock appreciation rights. Earnings for services under non-equity incentive plans, change in pension value, above market

earnings on deferred compensation and other compensation > $10,000.

Part C: Certification

I certify that to the best of my knowledge that all information on this form is correct.

____________________________________________________________________________________

Signature Date